Provider Demographics
NPI:1528545621
Name:HERNANDEZ, ALICIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:TX
Mailing Address - Zip Code:79782-1385
Mailing Address - Country:US
Mailing Address - Phone:432-268-3618
Mailing Address - Fax:
Practice Address - Street 1:4506 BRIARWOOD AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-2642
Practice Address - Country:US
Practice Address - Phone:432-689-6818
Practice Address - Fax:432-689-6901
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX138138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily